Abstract

Background

The aim of this study was to evaluate the relationship between intakes of energy-providing
macronutrients, and markers of cardio metabolic risk factors in high BMI African American
(AA) children.

Methods

A cross sectional analysis of a sample of 9-11 year old children (n = 80) with BMI
greater then the 85th percentile. Fasting hematological and biochemical measurements, and blood pressure
were measured as selected markers of cardio metabolic risk factors and their relationships
to dietary intakes determined.

Results

After adjusting for gender, pubertal stage and waist circumference (WC), multivariate
regression analysis showed that higher total energy intakes (when unadjusted for source
of energy) were associated with higher plasma concentrations of intermediate density
lipoprotein cholesterol (IDL-C) and very low density lipoprotein cholesterol (VLDL-C).
Higher intakes of carbohydrate energy (fat and protein held constant) were associated
with higher IDL-C, VLDL-C, triglycerides (TG) and homeostasis model assessment of
insulin resistance (HOMA-IR). Higher intakes of fat (carbohydrate and protein held
constant), however, were associated with lower IDL-C; and higher protein intakes (fat
and carbohydrate held constant) were associated with lower HOMA-IR.

Conclusion

The specific macronutrients that contribute energy are significantly associated with
a wide range of cardio metabolic risk factors in high BMI AA children. Increases in
carbohydrate energy were associated with undesirable effects including increases in
several classes of plasma lipids and HOMA-IR. Increases in protein energy were associated
with the desirable effect of reduced HOMA-IR, and fat energy intakes were associated
with the desirable effect of reduced IDL-C. This analysis suggests that the effect
of increased energy on risk of developing cardio metabolic risk factors is influenced
by the source of that energy.